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When to Go to the Emergency Room

Posted on Dec 30, 2013 | 0 comments

Nurse Examing PatientParents often wish they had a crystal ball to help them figure out whether their sick child needs urgent medical attention. Is the sore arm after a fall really broken? Is the rising fever a sign of serious illness?

Palo Alto Medical Foundation pediatrician Lauren Brave, M.D., says everyone wants to avoid unnecessary and costly trips to the emergency room, but it’s also important to trust your instincts as a parent. When in doubt, try to contact your doctor for advice. If you think your child’s life is in danger, don’t hesitate. Call 911 or head for the nearest ER.

Here are Dr. Brave’s top tips about how to handle urgent medical care for your child.

When should I go to urgent care instead of the emergency room?

Urgent care centers can treat moderate, unforeseen medical problems that – while not emergencies – require care within about 24 hours. For example, this might include a cut that needs stitches, abdominal pain, fever, vomiting and diarrhea, a sore throat, severe cough, or worsening of an existing condition, such as mild to moderate asthma. Routine injuries such as sprained ankles, simple fractures or minor falls are also appropriate for urgent care.

Urgent care centers differ in the types of medical care they can provide. Before you head to your local urgent care or after-hours care center, call first to find out if they can help with your child’s particular medical issue.

When should I head straight for the emergency room?

A true emergency is when an illness or injury puts your child’s health or life in serious jeopardy and treatment can’t be delayed. Examples include extreme difficulty breathing, unconsciousness, significant bleeding or a severe head injury. Call 911 immediately or go to the closest emergency room with your child.

There are some gray areas. Asthma, for example, is often a chronic, recurring problem. Most asthma attacks can be treated in an urgent care center but a very severe exacerbation can be life threatening. Deciding whether to call 911, go to the ER or go to urgent care depends on your child’s appearance and your judgment – you know your child best.

Another gray area is possible poisoning. If your child has or may have ingested something that may be poisonous but is alert and stable, call the California Poison Control Center immediately at 800-222-1222. The Poison Control Center staff can tell you what to do initially and where to seek medical care if needed.  Keep that important number posted in a visible location in your home. If you are at all concerned this may be serious, head to the closest emergency room.

When should I wait to see my child’s doctor?

If your child is not experiencing a life-threatening emergency or a health issue that requires urgent care (within about 24 hours), book an appointment so your child can be seen by his or her own doctor. The established relationship with your child’s doctor can make it easier for him or her to reach an accurate diagnosis and provide the best care for your child’s needs.

Particularly if you are concerned about a chronic health issue, such as longstanding abdominal pain or constipation, your child’s regular doctor is the best person to diagnose and treat your child.

Are there times I don’t need to take my child to the doctor?

For some health issues you don’t necessarily have to rush to the nearest urgent care center or your child’s doctor. Watchful care at home and supportive measures such as pain medication may be the best, and most comfortable, treatment choice for your child in instances including:

  • Fever: A fever is not necessarily a sign of concern if it is associated with routine cold symptoms such as a runny nose, sore throat or cough. A temperature of or above 100.5 F is considered a fever. Call your doctor if your child’s temperate is approaching 105 F or if he or she has had a fever for longer than 72 hours.
  • Ear pain/ache: If your child is older than two and suffering from ear pain due to a possible ear infection, the pain can be treated with ibuprofen (for example, Advil or Motrin) and you can monitor your child’s condition at home. Many uncomplicated ear infections resolve by themselves without the need for antibiotics. If your child develops a fever, the pain is not controlled with ibuprofen, or he or she does not improve after 48 to 72 hours, check in with your child’s doctor.
  • Vomiting/diarrhea: If your child starts vomiting or having diarrhea, you don’t need to immediately rush to the doctor. Remember to give your child little sips of water or Pedialyte regularly to ward off dehydration. If the vomiting and diarrhea continues for several hours without gradually spacing out and your child’s urine output drops (using the bathroom less than three times a day), contact the doctor.

BraveLaurenLauren Brave, M.D., is a board-certified pediatrician in the Palo Alto Medical Foundation’s Pediatric Urgent Care Department at the Palo Alto Center. Advice is not intended to take the place of an exam or diagnosis by a physician.

Please note that we are unable to respond to personal medical questions through the comments feature below. For information about personalized health care, or if you need help in choosing a PAMF physician, please visit Becoming a PAMF Patient (http://www.pamf.org/findadoctor) or call 1-888-398-5677. If you are a PAMF patient, you can email your doctor securely via our My Health Online program. Thank you

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